1. Technical Field
The present disclosure relates generally to therapeutic treatment. In particular, the present disclosure relates to a therapeutic treatment using a combination of ultrasound, electro-stimulation and vibrational stimulation for the treatment of the musculoskeletal system.
2. Description of the Prior Art
Weakened bone structure and improperly healed or slowly healing bone fractures may result in reduced quality of life. Quality of life may be improved for patients with bone fractures by ensuring rapid healing and by inhibiting the loss of bone mineral content (bone mass), and therefore bone strength, associated with fractures. Metabolic bone diseases, such as osteoporosis, also reduce the quality of life.
Osteoporosis is a pernicious disorder usually, but not exclusively, afflicting elderly women. The osteoporotic state can also be manifested by those who are confined to a bed and even to astronauts who are subjected to prolonged weightlessness. Osteoporosis occurs through a decrease in bone mass, which makes the afflicted bones more fragile and more susceptible to breakage.
The reduction in bone mass from osteoporosis results when destruction outpaces bone formation. The balance between destruction and formation is affected by hormones, calcium intake, vitamin D and its metabolites, weight, smoking, alcohol consumption, age, genetic determinants and especially exercise or other methods of dynamically loading the bone tissue as well as many other factors. Considering the vast array of factors which can compromise the healing process, any form of stimulation that can accelerate, augment and/or ensure the healing process are greatly needed.
Osteoporosis is not easily determined in its early phases as physical deformity is not yet evident. Because osteoporosis develops progressively, early diagnosis and appropriate treatment may avoid a serious condition. Appropriate diet and exercise can be used in early years to prevent the damaging effects of osteoporosis later in life.
Besides the nutritional and genetic causes of osteoporosis, bone loss also occurs from prolonged exposure to weightless environments, i.e., prolonged periods in space as experienced by the crews of the International Space Station. When these crews return to the normal gravity of Earth, there bone loss could make them more susceptible to fractures. The longer the duration of weightlessness experienced by an astronaut, the greater the resulting bone loss and, consequently, the greater the risk of injury or immobilization. Various techniques have been employed to minimize the impact of prolonged weightlessness with varying degrees of success.
Methods and apparatus for maintaining or promoting bone growth are described in numerous patents. For example, McLeod et al., U.S. Pat. Nos. 5,103,806, 5,191,880, 5,273,028, 5,376,065, 6,234,975, 6,561,991 B2 and 6,607,497 B2 all incorporated herein by reference, collectively describe means and methods for promoting bone growth and preventing bone loss. The method described in the above-referenced patents relates to a mechanical vibrational loading of bones to promote growth in a non-invasive procedure.
Mechanical loading on bone tissue at strains of between about 0.5 to about 500 microstrain and induced within a predetermined frequency range can prevent bone loss and enhance new bone formation. Such mechanical bone loading of tissue may be introduced by various systems, including vibrating floor plates and chairs such as ones used for the generation of resonant vibrations, electrical stimulation of muscles, isometric exercises, modulated ultrasound or transducers attached to the skin or external fixation devices to focus energy to the fracture site.
A method of using resonant vibrations for treating postural instability is described in U.S. Pat. No. 6,607,497 B2. The method includes the steps of (a) providing a vibration table having a non-rigidly supported platform; (b) permitting the patient to rest on the non-rigidly supported platform for a predetermined period of time; and (c) repeating the steps (a) and (b) over a predetermined treatment duration. Step (b) includes the steps of (b1) measuring a vibrational response of the patient's musculoskeletal system using a vibration measurement device; (b2) performing a frequency decomposition of the vibrational response to quantify the vibrational response into specific vibrational spectra; and (b3) analyzing the vibrational spectra to evaluate at least postural stability.
The method described in U.S. Pat. No. 6,607,497 B2 entails the patient standing on the vibration table or unstable standing platform, which includes at least one accelerometer mounted to the outboard side thereof. The patient is then exposed to a vibrational stimulus by the unstable standing platform. The unstable standing platform causes a vibrational perturbation of the patient's neurosensory control system. The vibrational perturbation causes signals to be generated within at least one of the patient's muscles to create a measurable response from the musculoskeletal system. These steps are repeated over a predetermined treatment duration for approximately ten minutes a day in an effort to improve the postural stability of the patient.